Nutrition Postgraduate Program, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil.
Faculty of Nutrition, Federal University of Alagoas, Maceió, AL, Brazil.
Br J Nutr. 2024 Jul 28;132(2):192-199. doi: 10.1017/S0007114524001119. Epub 2024 May 28.
This cross-sectional study employs structural equation modelling (sEM) to explore both direct and indirect effects of parental level of education and child individual factors on the length-for-age outcomes in children aged 6-24 months assisted by the Bolsa Família Program in the State of Alagoas. A total of 1448 children were analysed by the sEM technique. A negative standardised direct effect (sDE) of the children's younger age (sDE: -0·06; = 0·017), the use of bottle feeding (sDE: -0·11; < 0·001) and lack of a minimum acceptable diet (sDE: -0·09; < 0·001) on the length-for-age indicator was found. Being female (SDE: 0·08; = 0·001), a higher birth weight (SDE: 0·33; < 0·001), being ever breastfed (sdE: 0·07; = 0·004) and a higher level of parental education (SDE: 0·09; < 0·001) showed a positive SDE effect on the child's length-for-age. The model also demonstrated a negative standardised indirect effect (SIE) of the sweet beverage consumption (SIE: -0·08; = 0·003) and a positive effect of being ever breastfed (SIE: 0·06; = 0·017) on the child's length-for-age through parental level of education as a mediator. This research underscores the crucial role of proper feeding practices and provides valuable insights for the development of targeted interventions, policies and programmes to improve nutritional well-being and promote adequate linear growth and development among young children facing similar challenges.
这项横断面研究采用结构方程模型(SEM),探索了父母教育水平和儿童个体因素对巴西家庭援助计划(Bolsa Família Program)中 6-24 个月儿童年龄别身长的直接和间接影响。共有 1448 名儿童接受了 SEM 技术分析。研究发现,儿童年龄较小(sDE:-0.06;p=0.017)、奶瓶喂养(sDE:-0.11;p<0.001)和最低可接受饮食不足(sDE:-0.09;p<0.001)对年龄别身长指标有负向标准化直接效应(sDE)。女性(sDE:0.08;p=0.001)、出生体重较高(sDE:0.33;p<0.001)、曾母乳喂养(sDE:0.07;p=0.004)和父母教育水平较高(sDE:0.09;p<0.001)对儿童年龄别身长有正向标准化直接效应(sDE)。该模型还显示,甜饮料消费的标准化间接效应(SIE)为负(SIE:-0.08;p=0.003),而曾母乳喂养的标准化间接效应(SIE)为正(SIE:0.06;p=0.017),通过父母教育水平作为中介对儿童年龄别身长产生影响。本研究强调了正确喂养实践的重要作用,并为制定有针对性的干预措施、政策和方案提供了有价值的见解,以改善营养状况,促进面临类似挑战的幼儿充分线性生长和发育。